Resources & Info – Pudendal Neuralgia
Pudendal neuralgia is chronic pain related to the pudendal nerve. Your pudendal nerve runs from your lower back, along your pelvic floor muscles, out to your perineum (the skin between your pubic bone and your tailbone).
It supplies the skin between the anus and the clitoris (or a man’s penis) as well as the muscles of the urethra and the anus (see light green area below).
The nerves throughout our bodies are usually supple and stretchy. They slide smoothly when we go about our everyday lives. Think about how far the nerves in your arms stretch when you reach above your head. We can also gently squash them for a while before they let us know, like the ‘dead arm’ feeling of pins and needles. They usually recover fairly quickly, too.
When nerves go through a large trauma (like a big fall onto a hard surface or a difficult labour) or lots of repetitive small trauma (like years of straining with constipation or repetitive heavy physical exercise) they can become irritated. Your nervous system can then become sensitised so that pain is triggered at a lower level, and the response is greater. It’s as though the volume is turned up for pain.
Pudendal neuralgia can come about when your pudendal nerve is exposed to traumas, the nerve is irritated, or compressed by bulky pelvic floor muscles or tight ligaments.
Symptoms of pudendal neuralgia
The main symptom of this problem is pain. This can be highly variable. You might feel burning, electric shock, shooting, aching, itch or a raw feeling in your clitoris, labia, vagina (penis in men), urethra, perineum, anus or rectum. You might find it difficult to sit because of your pain.
You may also experience bladder and bowel irritation. Sometimes you can feel this irritation without feeling much pain. Occasionally there is a full sensation in vagina or rectum.
Sometimes pain can be felt into the buttocks, legs and feet. This is because the skin there is supplied by the same level of your spinal cord and your brain ‘perceives’ the pain in the skin of your buttocks, legs and feet.
You may also have associated bladder, bowel or sexual problems.